Marathon runners' reaction to potassium iontophoretic experimental pain: pain tolerance, pain threshold, coping and self-efficacy

There is equivocal evidence regarding pain responding in endurance athletes. When performing, their pain experience appears reduced but it is uncertain whether this persists when not competing or training. This study aimed to clarify how marathon runners perceive pain, and the influence of self-efficacy and coping strategy use on their pain threshold and tolerance when they are not affected by immediate exercise. Pain threshold and pain tolerance were assessed in 26 marathon runners and 26 age- and sex-matched non-runners using potassium iontophoresis as the experimental pain stimulus. Use of associative and dissociative coping strategies, and catastrophizing were assessed using the Cognitive Coping Strategies Inventory, and pain specific and general self-efficacy were measured. Elevated pain threshold, pain tolerance and self-efficacy in marathon runners were revealed. Pain specific self-efficacy accounted for 40% of the tolerance difference between the marathon and non-marathon groups. Coping and catastrophizing did not differ between the two groups but higher associative coping when accompanied by lower dissociative coping was related to higher pain tolerance. These results indicate that marathon runners have a reduced experience of pain compared with non-runners. This ability appears to be augmented by a high level of pain specific self-efficacy but is unaffected by the influence of general cognitive coping strategies, although higher associative coping and lower dissociative coping together were related to reduced pain tolerance independent of running involvement.